92 Decision Citation: BVA 92-10050
Y92
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
DOCKET NO. 90-25 837 ) DATE
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THE ISSUE
Entitlement to an increased rating for anxiety reaction,
evaluated as 30 percent disabling.
REPRESENTATION
Appellant represented by: Disabled American Veterans
ATTORNEY FOR THE BOARD
W. Pope, Counsel
INTRODUCTION
The veteran had active service from November 1947 to July
1953.
This matter came before the Board on appeal from a March
1990 rating decision of the Cleveland, Ohio, Regional
Office, hereinafter RO, and included the issue of entitlement
to service connection for the residuals of a stroke. The
notice of disagreement was received on April 4, 1990. The
statement of the case was issued on May 3, 1990. The sub-
stantive appeal was received on May 14, 1990. The veteran
is represented by the Disabled American Veterans, and that
organization submitted a written argument on his behalf
dated June 18, 1990. The appeal was received at the Board
on July 3, 1990, and docketed on July 10, 1990. Another
written argument was submitted by the veteran's representa-
tive on October 18, 1990. In January 1991, the Board
remanded the appeal to the RO in order to provide the veteran
with due process of law concerning the issue of entitlement
to service connection for the residuals of a stroke. The
supplemental statement of the case was issued on July 18,
1991. A statement in support of claim was received from the
veteran on July 25, 1991, reporting that he wanted to be
considered "for an increase on my nervous condition only."
Accordingly, the only issue properly before the Board for
appellate consideration is the issue of entitlement to an
increased rating for anxiety reaction. A written argument
was submitted by the veteran's representative dated August
20, 1991. The appeal was again received at the Board on
August 30, 1991, and docketed on September 6, 1991. Another
written argument was submitted by the veteran's representa-
tive on September 26, 1991.
CONTENTIONS OF APPELLANT ON APPEAL
The veteran and his representative contend, in essence, that
his service-connected anxiety reaction is productive of
greater impairment than reflected by the 30 percent rating
currently assigned. The veteran asserts that the VA examina-
tion in January 1990 was incomplete for the purposes of
evaluation of his service-connected anxiety reaction.
DECISION OF THE BOARD
For the reasons and bases hereinafter set forth, it is the
decision of the Board that the evidence of record supports
the assignment of an increased rating of 50 percent for
anxiety reaction.
FINDINGS OF FACT
1. All relevant evidence necessary for an equitable disposi-
tion of the veteran's appeal has been obtained by the RO.
2. The veteran has experienced an increase in anxiety and
irritability and diminished memory due to his service-
connected anxiety reaction which has reduced his social and
industrial effectiveness to the extent that there is consid-
erable impairment.
CONCLUSION OF LAW
A 50 percent rating for anxiety reaction is warranted.
38 U.S.C. §§ 1155, 5107 (1991); 38 C.F.R.§ 4.7, Part 4,
Code 9400 (1991).
REASONS AND BASES FOR FINDINGS AND CONCLUSION
Initially, the Board notes that the veteran's claim is well
grounded within the meaning of 38 U.S.C. § 5107 (1991), and
that all relevant facts have been properly developed for
pursuit of his appeal.
Private medical evidence discloses that the veteran was
hospitalized in April 1988 due to confusion, disorientation,
hallucinations and loss of touch with reality. A CAT scan
disclosed evidence of past infarctions and some cerebral
atrophy. The diagnoses included organic delusional syndrome
with paranoid ideation and probable multi-infarct dementia.
A VA psychiatric examination in January 1990 disclosed that
the veteran had a history of two psychiatric hospitaliza-
tions. The first hospitalization was during service, and
the second was in April 1988. The mental status examination
disclosed that the veteran was unable to speak clearly and
had difficulty with memory. He was oriented, but appeared
very tense and anxious. He denied hallucinations, delusions,
nightmares or flashbacks, but reported dreams about the
pastor of his church. He was not homicidal or suicidal.
The examiner indicated that the veteran lacked insight and
had poor judgment. The diagnoses were generalized anxiety
disorder, organic mental disorder with dementia secondary to
cerebrovascular accident, and depression. A private hospital
report disclosed that the veteran was hospitalized from July
to September 1990 with an admitting diagnosis of acute mental
status change. Examination revealed that he was able to
mouth words but was unable to fully speak. Further examina-
tion during hospitalization disclosed normal-pressure hydro-
cephalus, and a ventriculoperitoneal shunt was installed in
August 1990.
The Board wishes to point out that the disability rating
assigned for a service-connected disability may be based
only upon the symptomatology due to that disability.
Determination of the specific symptomatology attributable to
a service-connected disability becomes more complicated
when, as in the instant case, coexisting nonservice-connected
disabilities or intervening causes produce similar symptoms.
Although the veteran has asserted that the VA psychiatric
examination in January 1990 was incomplete, the Board finds
that the overall examination was sufficient for purposes of
evaluation of his service-connected anxiety reaction. The
Board finds that the symptomatology reported during this
examination, specifically increased anxiety and memory diffi-
culties, are indicative of social and industrial impairment
which more closely equates to considerable rather than defi-
nite impairment. However, it is not found that the impair-
ment level due to the service-connected disability at issue
is productive of severe social or industrial impairment.
Accordingly, based solely upon the symptomatology due to the
service-connected disability, the Board finds that a 50 per-
cent rating for anxiety reaction is warranted.
ORDER
An increased rating of 50 percent for anxiety reaction is
granted, subject to the laws and regulations governing the
effective dates of awards.
BOARD OF VETERANS' APPEALS
WASHINGTON, D.C. 20420
STEPHEN L. WILKINS U. H. ANG, M.D.
DANIEL J. STEIN
NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C. § 7266 (1991),
a decision of the Board of Veterans' Appeals granting less
than the complete benefit, or benefits, sought on appeal is
appealable to the United States Court of Veterans Appeals
within 120 days from the date of mailing of notice of the
decision, provided that a Notice of Disagreement concerning
an issue which was before the Board was filed with the
agency of original jurisdiction on or after November 18,
1988. Veterans' Judicial Review Act, Pub. L. No. 100-687,
§ 402 (1988). The date which appears on the face of this
decision constitutes the date of mailing and the copy of
this decision which you have received is your notice of the
action taken on your appeal by the Board of Veterans'
Appeals.